Giulia Pranteda

Unusual patterns of presentation of frontal fibrosing alopecia: A clinical and trichoscopic analysis of 98 patients

3. Chalmers TC, Smith H Jr, Blackburn B, et al. A method for assessing the quality of a randomized control trial. Control Clin Trials. 1981;2:31-49. 4. Harries MJ, Sun J, Paus R, et al. Management of alopecia areata. BMJ. 2010;341:c3671. 5. Alkhalifah A, Alsantali A, Wang E, et al. Alopecia areata update: part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010;62:177-188.

Role of Steroid Therapy in Pseudoxanthoma Elasticum-like Papillary Dermal Elastolysis

Pseudoxanthoma Elasticum-like Papillary Dermal Elastolysis (PXE-PDE) is a peculiar idiopathic elastolytic disorder that clinically resembles Psudoxanthoma elasticum (PXE). It is histologically characterized by a total or partial loss of elastic fibers in the papillary dermis. It more often affects elderly women and is characterized by asymptomatic and symmetrical yellowish papules localized predominantly on the neck, supraclavicular regions, and flexural areas. After analyzing a series of cases and the recent literature suggesting that glucocorticoids may down-regulate the elastin gene expression and elastin mRNA, in cultured human skin fibroblasts, we think that high dose and prolonged steroid therapy may contribute to the appearance of PXE-PDE lesions.

Acquired unilateral naevoid telangiectasia in a healthy boy.

Sir, Acquired unilateral naevoid telangiectasia (AUNT) is a rare disease predominantly affecting women in a hyperoestrogenaemic state. In some cases hypersensitivity of oestrogen and progesterone receptors is postulated. Few cases have been reported in males, and these are usually associated with liver dysfunction and hyper-oestrogenism. We observed a young boy with AUNT. No other disease was associated and no oestrogen and progesterone receptor abnormality was evident in the skin sample.

Chemotherapy‐induced alopecia management: Clinical experience and practical advice

Chemotherapy‐induced alopecia (CIA) is probably one of the most shocking aspects for oncological patients and underestimated by physicians. Among hair loss risk factors, there are treatment‐related aspects such as drug dose, administration regimen, and exposure to X‐rays, but also patient‐related characteristics. To the best of our knowledge, no guidelines are available about CIA management.

A preliminary study on topical cetirizine in the therapeutic management of androgenetic alopecia

Abstract Background: Androgenetic alopecia (AGA) is a common form of scalp hair loss that affects up to 50% of males between 18 and 40 years old. Several molecules are commonly used for the treatment of AGA, acting on different steps of its pathogenesis (Minoxidil, Finasteride, Serenoa repens) and show some side effects. In literature, on the basis of hypertrichosis observed in patients treated with analogues of prostaglandin PGF2a, it was supposed that prostaglandins would have an important role in the hair growth: PGE and PGF2a play a positive role, while PGD2 a negative one. Objective: We carried out a pilot study to evaluate the efficacy of topical cetirizine versus placebo in patients with AGA. Patients and methods: A sample of 85 patients was recruited, of which 67 were used to assess the effectiveness of the treatment with topical cetirizine, while 18 were control patients. Results: We found that the main effect of cetirizine was an increase in total hair density, terminal hair density and diameter variation from T0 to T1, while the vellus hair density shows an evident decrease. The use of a molecule as cetirizine, with no notable side effects, makes possible a good compliance by patients. Conclusion: Our results have shown that topical cetirizine 1% is responsible for a significant improvement of the initial framework of AGA.

Klinische, histologische und trichoskopische Korrelate bei Erkrankungen der Kopfhaut

Die dermatoskopische Untersuchung von Kopfhaut und Haar wird als Trichoskopie bezeichnet. Das einfache und nichtinvasive diagnostische Verfahren ist ein praktisches, überall einsetzbares Instrument zur Diagnose und Verlaufsbeobachtung von Haar- und Kopfhaut-Erkrankungen. Die Trichoskopie macht morphologische Strukturen sichtbar, die mit dem bloßen Auge nicht zu erkennen sind, und liefert dem Kliniker eine Reihe dermatoskopischer Befunde, die er für die Differenzialdiagnose benötigt. Die Beobachtungen in der Trichoskopie lassen sich in interfollikuläre und follikuläre Muster unterteilen. Kürzlich wurde zudem als Mischform die Kategorie des follikulär-interfollikulären Musters eingeführt. Einige dieser Muster sind spezifisch für eine einzelne Erkrankung der Kopfhaut, andere kommen bei mehreren vor. Bisherige Studien deuten darauf hin, dass der Einsatz der Trichoskopie die klinische Untersuchung verbessern kann; hierzu sind jedoch weiterführende Untersuchungen erforderlich. Die vorliegende Übersichtsarbeit beschreibt den aktuellen Kenntnisstand zu den trichoskopischen Merkmalen der häufigsten Kopfhaut-Erkrankungen und ihre jeweiligen histopathologischen und klinischen Korrelate.

Clinical, Histological and Trichoscopic Correlations in Scalp Disorders

Trichoscopy is the term coined for the dermoscopic imaging of scalp and hair. This diagnostic technique, simple and noninvasive, can be used as a handy bedside tool for the diagnosis and follow-up of hair and scalp disorders. It allows the recognition of morphologic structures not visible by the naked eye and provides the clinician with a range of dermoscopic findings necessary for differential diagnosis. Trichoscopy observation can be broadly grouped as interfollicular patterns and follicular patterns. Recently, a third mixed class, called the follicular plus interfollicular pattern, has been introduced. Some of these features are specific to a certain scalp disease, while others can be found in many hair disorders. Although studies suggest that the use of trichoscopy can improve clinical accuracy, further investigation is needed. This review provides update information on the trichoscopic features of the most common scalp disorders, striving to show a histopathological and clinical correlation.

The management of pseudomyogenic hemangioendothelioma of the foot: A case report and review of the literature

Pseudomyogenic hemangioendothelioma (PMH) is a rare, mostly indolent, endothelial neoplasm of low‐grade malignancy, often mimicking myoid and epithelioid tumors histologically. It is more frequent in young adult males and it usually presents with multiple cutaneous nodules, mostly localized at the extremities. It traverses several tissue planes simultaneously and can involve dermis, subcutis, skeletal muscle, and bone. Histologically, it is characterized by plump spindle cells with eosinophilic cytoplasm, often arranged in fascicles and epithelioid cells with “pseudomyogenic” morphology. Immunohistochemically, PMH is positive for Factor VIII, FLI‐1, INI‐1, vimentin, MDM2, CDK4, CD31, AE1/AE3, EMA, and P63. The efficacy of treatments is only partially known. Because of the frequent multifocal aspect of PMH, which contraindicates surgery, systemic treatments, such as gemcitabine, sirolimus, and everolimus are used. Based on our observation of multifocal PMH of the foot in a 17‐year‐old male patient, treated with gemcitabine with complete cutaneous response in a 2‐year follow‐up, we decided to discuss this rare tumor and underline its progression and therapeutic approaches. Thanks to a correct diagnosis, it is possible to avoid aggressive therapeutic approaches, which would be necessary for nonindolent diseases, such as sarcoma, which often needs amputation.

A “seasonal bromoderma” in a farmer

Bromoderma is a rare skin disease caused by the ingestion, inhalation, or contact with products containing bromides. We report a case of bromoderma in a 36‐year‐old farmer, characterized by remission during the spring and exacerbation during the winter. The recognition of the use of products containing bromides during the winter helped us to understand the cause of the clinical condition.

Intraläsionale Kryochirurgie zur Behandlung von Keloiden: Ergebnisse einer retrospektiven Studie

Hintergrund: Zur Behandlung von Keloiden sind schon viele verschiedene Ansätze versucht worden, doch die Ergebnisse sind häufig enttäuschend. Mit intraläsionaler Kryochirurgie könnten sich die Narben signifikant reduzieren lassen. Ziel: Beurteilung der klinischen Sicherheit und Wirksamkeit der intraläsionalen Kryochirurgie in der Behandlung von Keloiden. Von den Patienten wurden vor und nach der Behandlung Rückmeldungen zu Schmerzen, Juckreiz und ästhetischem Störungsempfinden eingeholt. Methoden: Insgesamt 10 Patienten mit 14 Keloiden, die auf konventionelle Behandlungsmaßnahmen nicht angesprochen hatten, wurden zwischen Oktober 2007 und Oktober 2013 in eine retrospektive Studie eingeschlossen. Die Wirksamkeit dieser Behandlung wurde an der Reduktion der Narbenfläche gemessen. Ergebnisse: Die Narbenfläche war nach der intraläsionalen Kryochirurgie bei allen Narben um durchschnittlich 58,5% verkleinert (durchschnittliche präoperative Keloid-Narbenfläche: 874,6 ± 954,1 mm2; durchschnittliche postoperative Keloid-Narbenfläche: 505,8 ± 1024,7 mm2; p = 0,002). Schmerzen und ästhetisches Störungsempfinden waren bei allen Patienten nach der Behandlung signifikant reduziert (p = 0,008 bzw. p = 0,012). Schlussfolgerung: Unsere Ergebnisse deuten darauf hin, dass die intraläsionale Kryochirurgie eine wirksame Option zur Behandlung von Keloiden ist. Übersetzung aus Dermatology 2014;229:263-270 (DOI: 10.1159/000365392)